Age Related Macular Degeneration (AMD) and Dietary Supplements

What is Age Related Macular Degeneration (AMD)?AMD is one of the most common causes of poor vision amongst retired people, with almost 50% of those over 75 years old suffering from somedegree of AMD.The retinaThe retina is at the back of the eye and acts like a film in a camera. It is the part of the eye that converts light into electrical signals that are then passed along the optic nerve to the brain to form the image we see.The macula areaThe macula is responsible for most of our central vision. Unfortunately, this is the part that macular degeneration affects most. It does not affect the retina outside this area as much, which means that your peripheral vision is preserved. The central vision may be affected in such a way that you may have difficulty in reading and seeing faces, but not total blindness.

Types of macular degeneration

·Dry AMD is a gradual thinning of the central retina which usually takes many years to develop. Once the cells in the retina are lost they cannot be replaced.·Wet AMD is caused by the growth of abnormal blood vessels underneath the retina. Unfortunately, these vessels tend to leak and the fluid accumulates in the retina, distorting its shape and affecting its health. This can lead to a sudden worsening of vision. Vision may become distorted causing straight lines to appear bent.

What are the treatment options?

Dry AMDMost affected suffer from dry AMD. Although the condition may gradually worsen over time, it will never cause total blindness. It only affects the central vision and the peripheral vision remains the same.New surgical treatments are now available that enable people with dry AMD to make the most of their remaining vision. The most advanced treatments are available at leading centres. These involve removing the natural lens of your eye and replacing it with a new plastic lens or lenses. These lenses slightly magnify and also direct the light rays onto a new part of the retina to enable you to see clearer.Please see www.eyemaxmono.com for more information.​Wet AMDA minority will suffer from wet AMD. Treatment is largely dependent on the level of vision retained and how badly the retina is affected. For a few people, laser treatment is appropriate, but for most a drug may be injected into the vitreous cavity of the eye using a fine needle. Usually eyedrops are all that is necessary to ensure that the injection is not painful. The drug reduces the leakage from the abnormal vessels but it may need to be injected every month for the effect to be maintained.There is a great deal of ongoing research in this area and as such treatment options are constantly changing.

Healthy Macula

Advanced AMD

Can glasses help?

You should make sure that you have an up-to-date pair of glasses. Full frame reading glasses are better than bifocals or varifocals. If you are having difficulty reading, please speak to one of our optometrists and ask to be referred to a Low Vision Aid Clinic for advice on magnifying aids. Extra lighting can help with reading.

Can You prevent AMD happening?

·If you are a smoker – stop smoking. Research has shown that smokers have a higher incidence of AMD. Stopping smoking will help decrease your overall risk as well as avoiding other medical problems.·A diet rich in fruit and green leafy vegetables appears to help protect against AMD.·In the last few years evidence has suggested that a significant number of people who develop age-related macular degeneration carry genes (inherited factors) which increase the risk. This is to do with how their immune systems work to clear the waste material generated by the retina with age. Applying gentle laser to the retina may stimulate the immune system to clear this waste material – this is the subject of trials being undertaken with a newly-developed laser designed to improve the health of the retina whilst protecting the delicate light sensitive cells necessary for sight.·It is not clear whether increased exposure to sunlight increases the risk of age-related macular degeneration- if there is an effect it is probably small. It is good advice for everyone, young and old, to wear a pair of UV blocking sunglasses, together with a wide brimmed hat, when outside in the sun.What about dietary supplements?

Results from the Age-Related Eye Disease Study published in 2001 show that taking supplements containing high levels of antioxidants and zinc can significantly reduce the risk of advanced AMD.People at high risk of developing advanced AMD lowered their risk by around 25% when they took a high-dose combination of vitamin C, vitamin E, beta-carotene and zinc.Evidence also suggests that high levels of the carotenoid pigments lutein and zeaxanthin and omega 3 fish oils rich in DHA and EHA may also be of benefit in reducing the rate of AMD progression. The effects of supplements containing these nutrients are the focus of further research (the Age-Related Eye Disease Study 2). For further information on AREDS2 please click here.Taking supplements helps patients with both the wet and dry forms of AMD. Previous studies have suggested that people with diets rich in green, leafy vegetables have a lower risk for developing AMD. However, the high levels of dietary supplements that were evaluated in the study are difficult to achieve from diet alone.

Risks associated with dietary supplements

A five year follow-up of patients taking the high dose preparations has shown no significant side effects, other than a mild increase of non-specific genito-urinary tract problems. Taking supplements containing high levels of zinc may cause a mild copper deficiency. Overall there were no serious side effects but due to the potential issues surrounding higher levels of zinc we have purposefully ensured that our supplements:·Do not contain more than the UK official guidelines recommended zinc safe level of 25mg per day ·Include copper to offset the risk of copper deficiency.

General advice

Television – sitting closer to the TV will help you see and will do no harm.

Driving – you must be able to read a number plate with ease at 20.5 metres (67 feet) to satisfy the DVLA standards. If you cannot, then your insurance is invalid and unfortunately you cannot drive.

Registration as partially-sighted or sight-impaired – If your vision is badly affected the ophthalmologist may ask you to sign a CVI (Certificate of Visual Impairment) form, which will then be sent to your local Social Services office and GP; this may entitle you to certain financial benefits and social services may visit you in your own home to assess whether you need any additional help or appliances. Alternatively, eye clinic staff may refer you to have an assessment by social services using a referral of visual impairment (this doesn’t require you to be registered as sight-impaired but you may not derive the financial benefits attached to registering a Certificate of Visual Impairment). Finally, your optometrist may issue you with a ‘low vision leaflet’ which contains details of organisations able to help people with impaired vision and which you can use to contact social services directly if you think you might need extra help.